<?php $this->load->view("general/header");?>
<div id="customer" class="page_">
    <div class="form">              
        <div class="form_header">Tambah Data Pelanggan / Penyewa Mobil</div>
        
        <div class="content_dataS">
        <form method="post" action="<?php echo site_url("customer/index");?>">
           	<div class="content_dataR">
           	
                <div  style="border-bottom:solid; width:80%"><strong>Pengiriman Invoice Kepada</strong></div>
               
                <div class="row">
                	<div class="col1"></div>
                   	<div class="col2"></div>
                </div>
                  
                <div class="row">
                    <div class="col1">Nama</div>
                    <div class="col2"><input type="text" name="nama_ship"  value="<?php echo set_value('nama_ship'); ?>"/> 
                        <div class="errorField"><?php echo form_error("nama_ship");?></div>
                    </div>
                </div>
                
                <div class="row">
                    <div class="col1">Perusahaan</div>
                    <div class="col2"><input type="text" name="perusahaan_ship" value="<?php echo set_value('perusahaan_ship'); ?>"/> 
                        <div class="errorField"><?php echo form_error("perusahaan_ship");?></div>
                    </div>
                </div>
                <div class="row">
                    <div class="col1">Nomor Telepon</div>
                    <div class="col2"><input type="text" name="no_telp_ship" value="<?php echo set_value('no_telp_ship'); ?>"/> 
                        <div class="errorField"><?php echo form_error("no_telp_ship");?></div>
                    </div>
                </div>
                <div class="row">
                    <div class="col1">Fax</div>
                    <div class="col2"><input type="text" name="fax_ship" value="<?php echo set_value('fax_ship'); ?>"/> 
                        <div class="errorField"><?php echo form_error("Fax_ship");?></div>
                    </div>
                </div>
                <div class="row">
                    <div class="col1">Alamat</div>
                    <div class="col2"><input type="text" name="alamat_ship" value="<?php echo set_value('alamat_ship'); ?>"/>
                        <div class="errorField"><?php echo form_error("alamat_ship");?></div>
                	</div>
                </div>
               	
                <div class="row">
                    <div class="col1"></div>
                    <div class="col2"><input type="text" name="alamat_ship_1" value="<?php echo set_value('alamat_ship_1'); ?>"/>
                        <div class="errorField"><?php echo form_error("alamat_ship_1");?></div>
                	</div>
                </div>
                 <div class="row">
                    <div class="col1"></div>
                    <div class="col2"><input type="text" name="alamat_ship_2" value="<?php echo set_value('alamat_ship_2'); ?>"/>
                        <div class="errorField"><?php echo form_error("alamat_ship_2");?></div>
                	
                </div>
                
                <div class="row" style="display:none">
                    <div class="col1"></div>
                    <div class="col2">RT : <input  style="width:10%" type="text" name="rt_ship"/>RW : <input style="width:10%" type="text" name="rw_ship"/></div>
				</div> 
                <div class="row">
                    <div class="col1">Kode Pos</div>
                    <div class="col2"><input type="text" name="kode_ship" value="<?php echo set_value('kode_ship'); ?>"/>
                        <div class="errorField"><?php echo form_error("kode_ship");?></div>
                    </div>
            	</div> 
            	<div class="row">
            		<div class="col1">Kota</div>
                	<div class="col2"><input type="text" name="kota_ship" value="<?php echo set_value('kota_ship'); ?>"/>
                		<div class="errorField"><?php echo form_error("kota_ship");?></div>
                	</div>
				</div>
                <div class="row">
            		<div class="col1">Provinsi</div>
                	<div class="col2"><input type="text" name="provinsi_ship" value="<?php echo set_value('provinsi_ship'); ?>"/>
                		<div class="errorField"><?php echo form_error("provinsi_ship");?></div>
                	</div>
				</div> 
            </div>
		</div>
            <div  style="border-bottom:solid; width:80%"><strong>Informasi Umum dan Informasi Kontak</strong></div>
           
            <div class="row">		
                                
                    <div class="col1">Staff</div>
                    <div class="col2"><?php echo get_username($this->session->userdata("user_id"));?></div>
                
            </div>
            
            <div id="copier">
            	<input type="button" id="butcop" onclick="javascript:copier(this.form)"/>
            </div>
            <div class="row">
            	<div class="col1">Nama</div>
                <div class="col2"><input type="text" name="nama"  value="<?php echo set_value('nama'); ?>"/> 
                	<div class="errorField"><?php echo form_error("nama");?></div>
                </div>
			</div>
            
        	<div class="row">
            	<div class="col1">Perusahaan</div>
                <div class="col2"><input type="text" name="perusahaan" value="<?php echo set_value('perusahaan'); ?>"/> 
                	<div class="errorField"><?php echo form_error("perusahaan");?></div>
                </div>
			</div>
        	<div class="row">
            	<div class="col1">Nomor Telepon</div>
                <div class="col2"><input type="text" name="no_telp" value="<?php echo set_value('no_telp'); ?>"/> 
                	<div class="errorField"><?php echo form_error("no_telp");?></div>
                </div>
			</div>
            <div class="row">
            	<div class="col1">Fax</div>
                <div class="col2"><input type="text" name="fax" value="<?php echo set_value('fax'); ?>"/> 
                	<div class="errorField"><?php echo form_error("fax");?></div>
                </div>
			</div>
            <div class="row">
            	<div class="col1">NPWP</div>
                <div class="col2"><input type="text" name="npwp" value="<?php echo set_value('npwp'); ?>"/> 
                	<div class="errorField"><?php echo form_error("npwp");?></div>
                </div>
			</div>
			<div class="row">
                <div class="col1">Alamat</div>
                <div class="col2"><input type="text" name="alamat" value="<?php echo set_value('alamat'); ?>"/>
                    <div class="errorField"><?php echo form_error("alamat");?></div>
                </div>
            </div>
            <div class="row">
                <div class="col1"></div>
                <div class="col2"><input type="text" name="alamat_1" value="<?php echo set_value('alamat_1'); ?>"/>
                    <div class="errorField"><?php echo form_error("alamat_1");?></div>
                </div>
            </div>

            
                        <div class="row">
                <div class="col1"></div>
                <div class="col2"><input type="text" name="alamat_2" value="<?php echo set_value('alamat_2'); ?>"/>
                    <div class="errorField"><?php echo form_error("alamat_2");?></div>
                </div>
            </div>
            
            <div class="row">
                <div class="col1">Kode Pos</div>
                <div class="col2"><input type="text" name="kode_pos" value="<?php echo set_value('kode_pos'); ?>"/>
                    <div class="errorField"><?php echo form_error("kode_pos");?></div>
                </div>
            </div> 
            <div class="row">
                <div class="col1">Kota</div>
                <div class="col2"><input type="text" name="kota" value="<?php echo set_value('kota'); ?>"/>
                    <div class="errorField"><?php echo form_error("kota");?></div>
                </div>
            </div>
            <div class="row" style="display:none">
                    <div class="col1"></div>
                    <div class="col2">RT : <input  style="width:10%" type="text" name="rt"/>RW : <input style="width:10%" type="text" name="rw"/></div>
				</div> 
            <div class="row">
                <div class="col1">Provinsi</div>
                <div class="col2"><input type="text" name="provinsi" value="<?php echo set_value('provinsi'); ?>"/>
                    <div class="errorField"><?php echo form_error("provinsi");?></div>
                </div>
            </div> 
            
        </div>
   		<div class="title" align="right">
           	<input  type="submit" name="btnSave" value="Save" class="button_red" />
        </div>
       	<div class="success"><?php echo (isset($success))?$success:"";?>&nbsp;</div>
        </form>
    </div>
   
</div>
<?php $this->load->view("general/footer");?>